From the restorative perspective, various methods are available to prevent the progression of non-carious cervical lesions. Direct, semi-direct, and indirect composite resin techniques and indirect ceramic restorations are commonly recommended. In this context, semi-direct and indirect restoration approaches are increasingly favored, particularly as digital dentistry becomes more prevalent. To illustrate this, we present a case report demonstrating the efficacy of hybrid ceramic fragments fabricated using computer-aided design (CAD)/computer-aided manufacturing (CAM) technology and cemented with resin cement in treating non-carious cervical lesions over a 48-month follow-up period. A 24-year-old male patient sought treatment for aesthetic concerns and dentin hypersensitivity in the cervical region of the lower premolar teeth. Clinical examination confirmed the presence of two non-carious cervical lesions in the buccal region of teeth #44 and #45. The treatment plan involved indirect restoration using CAD/CAM-fabricated hybrid ceramic fragments as a restorative material. After 48 months, the hybrid ceramic material exhibited excellent adaptation and durability provided by the CAD/CAM system. This case underscores the effectiveness of hybrid ceramic fragments in restoring non-carious cervical lesions, highlighting their long-term stability and clinical success.

To conduct a systematic review and meta-analysis to evaluate the risk and intensity of tooth sensitivity (TS) after topical application of desensitizers containing potassium nitrate before dental bleaching. We searched PubMed, Scopus, Web of Science, LILACS, BBO, Cochrane Library, and SIGLE. We also surveyed gray literature without restrictions. We meta-analyzed the data using the random-effects model to compare potassium nitrate and placebo in terms of risk and intensity of TS and color change (∆SGU or ∆E). The quality of the evidence was rated using the GRADE approach. The risk of bias (RoB) of the included studies was analyzed using the Cochrane RoB tool. After the database screening, 24 articles remained. A significant 12% lower risk for the groups where desensitizing agents were applied (p = 0.02), with a risk ratio of 0.88 (95% CI 0.78 to 0.98). About the intensity of TS, a significant average mean difference of − 0.77 units of VAS units (95%CI − 1.34 to − 0.19; p = 0.01) in favor of the desensitizer group. In the NRS scale, a significant average mean difference of − 0.36 (95% CI − 0.61 to − 0.12; p value = 0.004) in favor of the desensitizer group. No significant difference was observed in color change (p > 0.28) in ∆SGU and ∆E. Although a significant reduction in the risk and intensity of TS was observed in groups treated with a potassium nitrate at some point during the bleaching, the clinical significance of this reduction is subtle and clinically questionable. Color change is not affected by the use of agents. The reduction in the risk and intensity of TS with the topical application of potassium nitrate–based desensitizing agents in dental bleaching is subtle and maybe clinically questionable.

OBJECTIVETo evaluate the color change stability and patient satisfaction after one-year of at-home bleaching with 10% carbamide peroxide (CP) in trays with or without reservoirs.MATERIALS AND METHODSForty-six patients were subjected to bleaching with CP (3 h/daily; 21 days) with a bleaching tray with or without reservoirs. The color was measured one-month and one-year after the completion of bleaching using the spectrophotometer (ΔEab, Δ00 and ΔWi), and shade guide units (ΔSGU). Patients' satisfaction were assessed using a 5-point Likert Scale questionnaire. Data were submitted to paired t-test (α = 0.05).RESULTSNo significant difference between color change after one-month and one-year was observed (VITA Classical shade guide unit and the ΔWi; p > 0.53). Significant differences were observed for the VITA Bleachedguide 3D-MASTER shade guide, ΔEab and ΔE00 (p < 0.03). The level of patient satisfaction was similar between groups (p = 1.00).CONCLUSIONSBleaching tray design did not have any influence on the bleaching stability for the 10% CP (Opalescence PF, Ultradent). Patients were very satisfied with the bleaching outcomes regardless of the bleaching tray design.CLINICAL RELEVANCEPlacement of reservoirs in bleaching trays does not increase longevity of dental bleaching. No clinically important color rebound was observed 1 year after bleaching with 10% CP.

OBJECTIVES:This randomized triple-blind clinical trial, split-mouth design, evaluated the application effect of the desensitizing gel before and after in-office bleaching on tooth sensitivity. MATERIALS AND METHODS:In one group, the desensitizing gel was applied for 10 min before the bleaching with 35% hydrogen peroxide, and then application of placebo gel after (n = 90). In the other group, the desensitizing gel was applied before and after the bleaching procedure for 10 min (n = 90). The primary outcome was pain intensity assessed with a numeric rating scale and a visual analog scale. Color was evaluated by means of a digital spectrophotometer and a shade guides. RESULTS:The proportion of patients that experienced pain in the side of before application was 90% (95% CI 82 to 94.6%), while the side of before and after was 93% (95% CI 86.2 to 96.9%), without significant difference between groups (OR = 0.25; 95% CI 0.005 to 2.52; p = 0.37). Pain was correlated in both groups, for the NRS scale (p < 0.0001) and the VAS scale (p < 0.0001) in all assessment periods. Significant whitening was detected, and no significant difference of color change was observed between groups (p > 0.45). CONCLUSIONS:The application of the desensitizing agent did not influence the effectiveness of bleaching, but it was not efficient in reducing the sensitivity, when applied before the procedure, or before and after. CLINICAL RELEVANCE:The use of a desensitizing gel before or after in-office bleaching does not reduce incidence or intensity of tooth sensitivity.

Purpose: This double-blind, randomized clinical trial evaluated the influence of dentin moisture on postoperative sensitivity (POS) in posterior restorations using a simplified etch-and-rinse adhesive, until 12 months of clinical service. Methods: 90 restorations were inserted in 45 patients to treat carious lesions or to replace existing posterior restorations with a depth >= 3 mm. After cavity preparation, the simplified etch-and-rinse adhesive (Adper Single Bond 2) was applied on dry or wet dentin followed by a bulk-fill resin composite (Filtek Bulk Fill) under rubber dam isolation. The patient's spontaneous and stimulated POS was evaluated at baseline and after 7 days, 6 months, and 12 months of clinical evaluation. The secondary parameters (marginal discoloration, marginal adaptation, fracture and recurrence of caries) were evaluated by World Dental Federation (FDI) criteria after 7 days, 6 and 12 months of clinical evaluation. Results: No significant spontaneous and stimulated POS was observed when dry and wet dentin were compared (P> 0.05). A significant and higher risk of spontaneous POS (18.6%; 95% CI 9.7 to 32.6) occurred up to 48 hours after restoration placement for both groups when compared to all evaluation times (P< 0.03). However, the intensity of POS was mild at up to 48 hours with a difference between the dry and wet dentin groups (P> 0.79). When secondary parameters were evaluated, no significant difference between the groups were observed (P> 0.05).

O clareamento dental e um meio procurado pela sociedade a fim de obter dentes mais brancos, porem pode ocasionar efeitos colaterais como sensibilidade dental, que esta diretamente relacionada a concentracao do agente clareador e o tempo que permanece em contato com os dentes. O objetivo deste trabalho foi verificar a efetividade, estabilidade da cor e sensibilidade ao clareamento dental com peroxido de hidrogenio (H 2 O 2 ) nas concentracoes de 10% (White Class com Calcio - FGM, Joinville, SC, Brasil) e 35% (Whiteness HP Maxx - FGM, Joinville, Santa Catarina, Brasil). Os geis foram aplicados sob o mesmo protocolo de duas sessoes com intervalo de 7 dias, sendo que cada sessao correspondeu a 3 aplicacoes de 15 minutos. A sensibilidade dental foi registrada pelos proprios pacientes atraves das escalas VAS (0-10) e NRS (0-4). Ambas as concentracoes promoveram clareamento de forma satisfatoria, H 2 O 2 10% demonstrou menores indices de sensibilidade dental.

Objectives This randomized, split-mouth, single-blinded trial assessed whether the use of reservoirs in at-home bleaching trays is equivalent to non-reservoir trays. Our choice of an equivalence trial was based on the expectation that a non-reservoir tray is sufficient to produce a color change. Secondary outcomes such as tooth sensitivity (TS) and gingival irritation (GI) were also assessed. Methodology Forty-six patients were selected with canines shade A2 or darker. In half of the patient's arch, bleaching trays were made with reservoirs and the other half, without reservoirs. At-home bleaching was performed with carbamide peroxide (CP) 10% (3 h daily; 21 days). Color change was evaluated with a digital spectrophotometer (ΔE, ΔE00, and Whiteness Index) and shade guide units (ΔSGU) at baseline, during and one-month post-bleaching. TS and GI were assessed with a numeric scale (NRS) and a visual analog scale (VAS). Results After one month, the equivalence of reservoir and non-reservoir groups were observed in all color instruments (p>0.05). Fifteen and sixteen patients presented pain (absolute risk: 33% and 35%, 95%, confidence interval (CI) 21-46% and 23-49%) in the reservoir and non-reservoir side, respectively. The odds ratio for pain was 0.8 (95%CI 0.2-3.0) and the p-value was non-significant (p=1.0). TS intensity was similar between both groups in any of the pain scales (p>0.05). No difference in the GI was observed (p>0.05). Conclusions The protocol with reservoirs is equivalent in color change to the non-reservoir, although no superiority of the latter was observed in terms of reduced TS and GI with at-home 10% carbamide peroxide bleaching. Clinical Relevance The presence of reservoirs in a bleaching tray did not improve color change or affect tooth sensitivity and gingival irritation.

O objetivo deste estudo clínico foi avaliar, por 7 semanas, a eficácia de dentifrícios clareadores e a satisfação dos pacientes após o uso. Foram selecionados 30 pacientes que possuíssem todos os dentes anteriores nas arcadas superior e inferior, apresentando cor inicial A2, avaliados através da escala de cores Vita Classical (Vita Zahnfabrik, Bad Säckingen, Alemanha). Os participantes foram aleatoriamente divididos em 3 grupos (n=10): GA - Colgate® Máxima Proteção Anticáries (controle negativo), GB - Colgate® Luminous White e GC - Colgate® Luminous White Advanced. Os dentifrícios foram distribuídos em bisnagas idênticas e aleatorizados. As avaliações de cor foram realizadas inicialmente ao uso (baseline), após 7, 15, 30 e 60 dias, utilizando dois métodos: avaliação subjetiva com as escalas de cor Vita Classical (Vita Zahnfabrik, Bad Säckingen, Alemanha) e Vita Bleachedguide 3D-MASTER (Vita Zahnfabrik, Bad Säckingen, Alemanha), e avaliação objetiva através do espectrofotômetro VITA Easyshade Compact®, Vident, Brea, CA, USA). Foi considerada a satisfação do paciente quanto a mudança de cor dos dentes. Os dados foram submetidos à análise estatística, utilizando análise de variância (ANOVA) de três critérios e pós-teste de Tukey (α=0.05). Os resultados demonstraram que houve diferença de cor estatisticamente significante nos grupos em que se utilizou os dentifrícios clareadores (GB e GC), nos períodos entre 15 e 30 dias. Conclui-se que ambos os dentifrícios GB e GC apresentaram ação clareadora, observado através das escalas subjetiva e objetiva. Porém, na percepção do paciente apenas no grupo GC houve mudança de cor.Palavras-chave: Dentifrícios. Clareamento Dental. Estética Dentária.AbstractThe objective of this clinical study was to evaluate, for 7 weeks, the efficacy of whitening dentifrices and the patients' satisfaction after use. 30 patients were selected who had all the anterior teeth in the upper and lower arches, presenting an initial color A2, evaluated through the Vita Classical color scale (Vita Zahnfabrik, Bad Säckingen, Germany). The participants were randomly divided into 3 groups (n = 10): GA - Colgate® Maximum Antibody Protection (Negative Control), GB - Colgate® Luminous White and GC - Colgate® Luminous White Advanced. The dentifrices were distributed in identical and randomized tubes. The color evaluations were performed at baseline after 7, 15, 30 and 60 days using two methods: subjective evaluation with the Vita Classical (Vita Zahnfabrik, Bad Säckingen, Germany) and Vita Bleachedguide 3D- MASTER (Vita Zahnfabrik, Bad Säckingen, Germany), and objective evaluation using VITA Easyshade Compact® spectrophotometer, Vident, Brea, CA, USA). The patient's satisfaction with the teeth color change was considered. The data were submitted to statistical analysis using ANOVA of three criteria and Tukey post-test (α = 0.05). The results showed that there was a statistically significant difference in color in the groups in which the whitening dentifrices were used (GB and GC), in periods between 15 and 30 days. It was concluded that both GB and CG dentifrices presented a whitening action, observed through the subjective and objective scales. However, in the perception of the patient only in the CG group there was a change of color.Keywords: Dentifrices. Tooth Bleaching. Esthetics, Dental.

Justificativa: Reservatorios sao modificacoes em moldeiras de clareamento caseiro que visam acumular maior quantidade de gel disponivel ao dente, buscando maior eficacia clareadora. Os primeiros relatos sobre a eficacia dos reservatorios vem do final da decada de 1990. No entanto, os beneficios de sua confeccao ainda nao estao claros. Objetivo: Este relato de caso de boca dividida teve como objetivo avaliar se o uso de reservatorios em moldeiras de clareamento caseiro pode afetar o risco e intensidade da sensibilidade dentaria e da irritacao gengival e aumentar a eficacia do clareamento. Relato de Caso: O clareamento foi realizado utilizando moldeira na qual o lado esquerdo teve a confeccao de reservatorios e nenhum procedimento realizado no lado direito. O gel utilizado foi o peroxido de carbamida a 10%, com aplicacao de 3 horas por dia, durante 21 dias. A eficacia clareadora foi avaliada por metodos subjetivos utilizando escala de cor (VITA Classical e VITA Bleachedguide 3D-MASTER) e objetiva utilizando espectrofotometro VITA Easyshade. Foi aplicado questionario de adesao as orientacoes; escala analogica visual (VAS) e escala de classificacao numerica de 5 pontos (NRS) para avaliar risco e intensidade da sensibilidade dental, tambem foi questionado sobre irritacao gengival a cada dia de tratamento. O paciente foi avaliado inicialmente, apos 7, 14 21 dias, alem disso, 30 dias apos um mes da finalizacao do tratamento. Resultados: Clareamento significativo foi observado em ambos os lados sob a avaliacao subjetiva e objetiva. Nao foi observada diferenca em relacao a sensibilidade dental e irritacao gengival para nenhum dos protocolos de clareamento. Conclusao: Nao foram observadas diferencas na eficacia clareadora, risco e intensidade da sensibilidade dental e irritacao gengival, com e sem a presenca de reservatorio nas moldeiras. Ha necessidade de um estudo clinico controlado e randomizado para avaliar estatisticamente essa hipotese. Descritores: Clareamento Dental; Reservatorios; Relato de Caso.

To answer the following focused question through a systematic review: "Are the risk and intensity of tooth sensitivity (TS) and bleaching efficacy different between adult patients who undergo at-home bleaching using trays with reservoirs and those who use trays without reservoirs?". A comprehensive search was performed in the MEDLINE via PubMed, Scopus, Web of Science, Latin American and Caribbean Health Sciences Literature database, Brazilian Library in Dentistry, Cochrane Library, and grey literature without restrictions. Abstracts from conferences; unpublished and ongoing trial registries, dissertations and theses (ProQuest Dissertations and Periódicos Capes Theses databases) were searched. Only randomized clinical trials (RCTs) were included. We used the Risk of Bias tool (RoB) from the Cochrane Collaboration for quality assessment. After the removal of duplicates, title and abstract screening and full-text examination, nine RCTs remained for qualitative analyses. The great majority of the studies did not report the method of randomization, allocation concealment, and examiner blinding during color assessment. From the nine studies, eight were at unclear risk of bias. In regard to color change, four studies reported no change and two reported improved color change with reservoirs. Only four studies recorded tooth sensitivity and they reported no significant differences. Only one study reported greater gingival irritation with reservoirs. Lack of data reporting prevented us from running a meta-analysis. Further well-designed RCT should be conducted to answer this research question. So far there is not evidence to support that reservoirs in bleaching trays improve color change. PROSPERO - CRD42016037628.

O objetivo foi avaliar se a resina composta fluida em lesões cervicais não cariosas (LCNCs) melhora as taxas de retenção, descoloração marginal e adaptação, em pacientes adultos, por meio de uma revisão sistemática e metanálise. Foram pesquisadas sem restrições as bibliotecas Medline, Scopus, Web of Science, Lilacs, BBO, Cochrane Library e SIGLE (bases cinzentas), resumos do IADR e registros de ensaios clínicos (REBEC). Dissertações e teses também foram pesquisadas através das bases de dados ProQuest Dissertações e Periódicos Capes Teses. Foram incluídos apenas ensaios clínicos randomizados que compararam as restaurações com resina composta fluida e resina composta de viscosidade regular em LCNCs. A ferramenta da Cochrane Collaboration foi utilizada para avaliar o risco de viés dos estudos elegíveis. A ferramenta GRADE foi usada para avaliar a qualidade da evidência para cada estudo, de acordo com seus resultados. Após a remoção de duplicatas e avaliação por títulos e abstracts, 8 estudos mantiveram-se para a análise qualitativa. Não foi observada diferença significativa entre os grupos quanto a retenção nem descoloração marginal em todos os períodos avaliados (1 a 3 anos). Observou-se melhor adaptação marginal para as restaurações que foram realizadas com resina fluida. A qualidade da evidência foi classificada como moderada para perda ou retenção aos 3 anos e baixa e/ou muito baixa para todos os outros desfechos. Concluiu-se que a viscosidade da resina composta não influencia as taxas de retenção e descoloração marginal das restaurações em LCNCs.Palavras-chave: Lesões Cervicais. Flow. Ensaio Clínico Randomizado. Revisão Sistemática.

Avaliar a resistência de união (TBS) e nanoinfiltração (NL) de sistemas adesivos universais em dentina erosionada (DE) na estratégia self-etch e etch-and-rinse. Duzentos molares foram aleatoriamente distribuídos de acordo com a combinação das variáveis independentes: Superfície dentinária (dentina sadia e dentina erosionada) vs. Sistema adesivo [1) All Bond Universal 2) Ambar Universal 3) Clearfil Universal 4) Futurabond Universal 5) One Coat 7 Universal 6) Peak Universal Bond 7) Prime & Bond Elect 8) Scotchbond Universal 9) Tetric N-Bond Universal 10) Xeno Select] vs. estratégia adesiva [self-etch (SE) e etch-and-rinse (ER)]. Para desafio erosivo, foram realizados ciclos de/remineralização por 10 dias com ácido cítrico. Após aplicação e fotoativação dos sistemas adesivos de acordo as instruções do fabricante, os dentes foram restaurados, armazenados em água por 24 h, seccionados em “palitos” e submetidos ao teste de microtração sob tensão (0,5 mm/min). 3 palitos de cada dente foram imersos em solução de nitrato de prata para análise de NL por microscopia eletrônica de varredura. Os dados foram analisados por ANOVA três fatores e teste de Tukey (5%). Os valores de TBS em DE foi estatisticamente inferior à dentina sadia, independente da estratégia adesiva (p<0,01). Em DE não houve diferença entre as estratégias adesivas (p>0,61). Uma maior deposição de nitrato de prata foi observada em DE (p <0,002). A erosão diminuiu a TBS, aumentou a NL independente da estratégia adesiva e as variações na composição dos adesivos produziu diferentes desempenhos.Palavras-chave: Adesivos Dentinários. Resistência à Tração. Erosão Dentária.

Background. In this randomized study, split-mouth, triple-blind clinical trial, the authors evaluated the efficacy of a desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde applied before in-office bleaching with 35% hydrogen peroxide (HP). Methods. Treatment with the desensitizing or placebo control gels was randomly assigned to onehalf of the maxillary teeth of 42 patients in a split-mouth design. The desensitizing gels were applied and maintained in contact with the tooth enamel for 10 minutes, followed by 2 HP bleaching sessions separated by 1 week. The primary outcome variable was pain intensity assessed with a numeric rating scale and a visual analog scale. Color was evaluated by means of a digital spectrophotometer and a value-oriented shade guide. Results. The difference in risk of developing tooth sensitivity between the desensitizing gel group (31.7%, 95% confidence interval [CI], 19.6 to 46.9) and the control group (70.7%; 95% CI, 55.5 to 82.3%) was statistically significant (P < .0001), as well as the difference in pain intensity in the first 24 hours (P < .001). No statistically significant difference was found in color change between teeth that received the desensitizing gel and those that received the placebo gel. Conclusions. Application of desensitizing gel that contained 5% potassium nitrate and 5% glutaraldehyde before HP whitening reduced the risk and severity of dental sensitivity, without altering the effectiveness of whitening.

Justificativa: Reservatorios sao modificacoes em moldeiras de clareamento caseiro que visam acumular maior quantidade de gel disponivel ao dente, buscando maior eficacia clareadora. Os primeiros relatos sobre a eficacia dos reservatorios vem do final da decada de 1990. No entanto, os beneficios de sua confeccao ainda nao estao claros. Objetivo: Este relato de caso de boca dividida teve como objetivo avaliar se o uso de reservatorios em moldeiras de clareamento caseiro pode afetar o risco e intensidade da sensibilidade dentaria e da irritacao gengival e aumentar a eficacia do clareamento. Relato de Caso: O clareamento foi realizado utilizando moldeira na qual o lado esquerdo teve a confeccao de reservatorios e nenhum procedimento realizado no lado direito. O gel utilizado foi o peroxido de carbamida a 10%, com aplicacao de 3 horas por dia, durante 21 dias. A eficacia clareadora foi avaliada por metodos subjetivos utilizando escala de cor (VITA Classical e VITA Bleachedguide 3D-MASTER) e objetiva utilizando espectrofotometro VITA Easyshade. Foi aplicado questionario de adesao as orientacoes; escala analogica visual (VAS) e escala de classificacao numerica de 5 pontos (NRS) para avaliar risco e intensidade da sensibilidade dental, tambem foi questionado sobre irritacao gengival a cada dia de tratamento. O paciente foi avaliado inicialmente, apos 7, 14 21 dias, alem disso, 30 dias apos um mes da finalizacao do tratamento. Resultados: Clareamento significativo foi observado em ambos os lados sob a avaliacao subjetiva e objetiva. Nao foi observada diferenca em relacao a sensibilidade dental e irritacao gengival para nenhum dos protocolos de clareamento. Conclusao: Nao foram observadas diferencas na eficacia clareadora, risco e intensidade da sensibilidade dental e irritacao gengival, com e sem a presenca de reservatorio nas moldeiras. Ha necessidade de um estudo clinico controlado e randomizado para avaliar estatisticamente essa hipotese. Descritores: Clareamento Dental; Reservatorios; Relato de Caso.

PURPOSE To compare the enamel bonding performace of two commercial and three experimental two-step self-etch adhesives containing acidic functional monomers with different carbon-spacer length and hydrophilicity. The contact angle was also assessed to evaluate the wettability of each tested material. MATERIALS AND METHODS Forty extracted human molars were sectioned into four parts (buccal, lingual, mesial, and distal) and divided into 5 groups, according to the adhesives used: Clearfil SE Bond (CSE), AdheSE (ADSE), 10-MDP (15 mol% 10-methacryloyldecylphosphate), CAP-P (15 mol% caprolactone phosphate), and MTEP (15 mol% methacryloyltetraethylene phosphate). Enamel specimens were bonded with each adhesive and submitted to microshear bond strength (μSBS) testing after 24 h. The adhesives were applied onto additional enamel specimens without light curing to assess contact angle. Then the etching pattern was analyzed using SEM and confocal laser scanning microscopy (CLSM). The μSBS and contact angle data were analyzed by one-way ANOVA and Tukey's test (α = 0.05). RESULTS 10-MDP showed the highest μSBS of the tested groups (p < 0.05), followed by CAP-P and CSE (p < 0.05). MTEP and ADSE exhibited the lowest μSBS (p < 0.05), but the difference between them was not significant. 10-MDP, CSE, and CAP-P exhibited lower contact angles (p < 0.05) than did ADSE and MTEP. The SEM and CLSM analyses showed that 10-MDP and CSE had the most pronounced etching patterns and deepest adhesive penetration. ADSE and MTEP exhibited weak etching ability and adhesive penetration, while CAP-P produced moderate etching and intermediate penetration. CONCLUSIONS The length and hydrophilicity of the functional monomer spacer chain tested in this study influenced the enamel bonding performance. Functional monomers with longer chains and more hydrophobic properties, such as 10-MDP and CAP-P, may interact better with enamel and achieve higher enamel bond strength.

OBJECTIVES The aim of this study was to investigate the effect of different protocols of 17% ethylene diamine tetra-acetic acid (EDTA) conditioning on the etching pattern and immediate bond strength of universal adhesives to enamel and sclerotic dentin. METHODS AND MATERIALS Forty bovine teeth with sclerotic dentin and 20 human third molars were randomly divided into eight groups resulting from the combination of the main factors surface treatment (none, two-minute EDTA conditioning manual application, 30-second EDTA manual application, 30-second EDTA sonic application) and adhesives systems (Scotchbond Universal Adhesive [SBU] and Prime & Bond Elect [PBE]). Resin-dentin and enamel-dentin bond specimens were prepared and tested under the microtensile bond strength (μTBS) and microshear bond strength (μSBS) tests, respectively. The etching pattern produced on the unground enamel and the sclerotic dentin surfaces under the different protocols and adhesive systems was evaluated under scanning electron microscopy. RESULTS For enamel, only the main factor adhesive was significant (p<0.0001), with SBU showing the highest μSBS. In sclerotic dentin, the lowest mean was observed for the group without EDTA application and the highest mean in the group with EDTA application with the sonic device for 30 seconds. Regardless of the EDTA protocol, the highest means of μTBS were observed for SBU (p<0.05). CONCLUSIONS EDTA conditioning improves the bonding performance of universal adhesives in the self-etch mode on sclerotic dentin, mainly when applied for 30 seconds with the aid of a sonic device. EDTA pretreatment also improves the retentive etching pattern of enamel, but it does not result in higher enamel bond strength.

ObjectivesTo answer the following PICO question (participant, intervention, comparator and outcome): Does flowable resin composite restorations compared with regular resin composites improve the marginal adaptation, marginal discoloration and retention rates of restorations placed in non-carious cervical lesions [NCCLs] of adults?, through a systematic review and meta-analysis.SourceMEDLINE, Scopus, Web of Science, LILACS, BBO, Cochrane Library and SIGLE were searched without restrictions, as well as the abstracts of the IADR, clinical trials registries, dissertations and theses in May 2016 (updated in April 2017).Study selectionWe included randomized clinical trials (RCTs) that answered the PICO question. RCTs were excluded if cavities other than NCCLs were treated; indirect restorations; polyacid-based resins instead of composite resins were employed, restorations in primary teeth and restorations were placed in carious cervical lesions. The risk of bias tool of the Cochrane Collaboration was applied in the eligible studies and the GRADE tool was used to assess the quality of the evidence.DataAfter duplicates removal, 5137 articles were identified. After abstract and title screening, 8 studies remained. Six were at “unclear” risk of bias. The study follow-ups ranged from 1 to 3 years. No significant difference was observed between groups for loss of retention and marginal discoloration in all follow-ups. Better marginal adaptation was observed for restorations performed with flowable composites. At 1-year (risk ratio=0.27 [0.10 to 0.70]) and 3-year (risk ratio=0.34 [0.17 to 0.71]) follow-ups, flowable composites showed a risk 73% and 66% lower than regular composites for lack of adaptation, respectively. The evidence was graded as moderate quality for loss or retention at 3 years due to risk of bias and low and very low for all other outcomes due to risk of bias, imprecision and inconsistency.ConclusionsWe have moderate confidence that the resin composite viscosity does not influence the retention rates at 3 years. Similar marginal discoloration and better marginal adaptation was observed for flowable composites but the quality of evidence is doubtful. (PROSPERO CRD42015019560).

Resumo Objetivo Avaliar in vitro a capacidade de remoção de pigmentos ocasionados em resina composta após aplicação de peróxido de hidrogênio 35%. Material e método Confeccionaram-se 20 amostras de resina composta Opallis (FGM), cor A1, em matriz metálica circular. As amostras foram divididas em quatro grupos (n=5) dos seguintes agentes corantes: água destilada (controle), café, vinho tinto e Coca-Cola®. No manchamento, as amostras ficaram imersas nas soluções durante 72 horas, com troca diária das bebidas. Procedeu-se à aplicação do gel de peróxido de hidrogênio 35% (Whiteness HP Blue Calcium, FGM) em três sessões, sendo uma aplicação do gel por sessão, o qual permaneceu nas amostras durante 40 minutos. Medidas de cor foram feitas inicialmente, após manchamento, após aplicação do peróxido e por mais 21 dias, usando espectrofotômetro Vita Easyshade. Os dados foram submetidos à análise de variância de dois fatores (tempo vs. corante) e ao teste de Tukey, para o contraste das médias (α=0,05). Resultado Apresentaram alteração de cor (ΔE - média/desvio padrão de L*) o café (15,7 ± 2,0) e o vinho (15,2 ± 4,6), quando comparados à Coca-Cola® (4,8 ± 1,9). O peróxido de hidrogênio removeu a pigmentação das amostras, porém, para nenhum dos corantes, houve retorno à coloração inicial, principalmente no grupo manchado por café (12,9 ± 1,5); este mostrou diferença significativa quando comparado ao controle (1,6 ± 0,6), diferentemente do vinho (3,3 ± 0,6) e da Coca-Cola® (2,1 ± 0,9), que se aproximaram do grupo controle. Conclusão As soluções corantes pigmentaram a resina composta, principalmente o café. A aplicação do peróxido de hidrogênio 35% foi eficaz na remoção de pigmentos das amostras, porém, em nenhum dos grupos, com diferentes corantes, houve retorno à coloração inicial (p>0,005).